When you have children your life changes. You’re completely responsible for another life which is an immense responsibility. We all do our best but still make mistakes.

The key is how you handle those mistakes.

Do you grow from it? Do you ignore it and hope it goes away? Do you keep reinforcing possibly negative or detrimental patterns? Do you acknowledge it and realize you can change it? Can you get over yourself enough to put your children first?

These are all tough questions we have to ask ourselves when raising children from both a mental health and chronic disease standpoint.

Addressing Emotions to Prevent Eczema and Autoimmunity in Kids

My husband and I are both acutely aware of the importance of mental health issues being healthcare practitioners. We’re trained to identify anxiety, depression, and other conditions as they are so prevalent in society. (This needs to be acknowledged and solutions offered).

From a personal aspect we also understand because we both come from families where there is a history of mental illness and mood disorders to varying degrees. We both agree that while our parents tried, we wish they made these considerations for us and our families as children and teens.

We’re not saying that we had horrible childhood’s by any stretch of the imagination. However, neither of us feel we were given great emotional coping tools- something we work on in our home daily.

And guess what…. we’re not perfect and we don’t always get it right. But, we are always aware, practice self reflection, and try to do better the next time.

Nothing frustrates me more than when my son lies to me. His are more like omissions or being sneaky. For example, the day after Halloween the Switch Witch came which meant the candy went away in place of a small toy. I left a few pieces of candy I bought that were made with better ingredients and allergen friendly that he could have occasionally.

He asked for the candy and I said no. He asked again and I said no again.

I thought the issue died, but then found a wrapper on the bathroom floor.

I asked him about it and he fessed up. He said he just wanted it and that’s why he did it (and let’s face it…little kids are ruled by their desires). I didn’t yell (but sometimes I do and often regret it). I said I that was disappointed and no treats all weekend.

Hopefully a lesson was learned?!?!?!

Current research and my friend Dr. Keesha Ewers book, “Solving the Autoimmune Puzzle,” says that these “little issues” can add up and do damage as adults (you can take an Adverse Childhood Events/ACES quiz here for you or your kids):

– Prevent us from fully achieving our own personal greatness because of self doubt and sabotage

– Create dysfunctional relationships

We want to avoid the discord that arises when issues aren’t dealt with. Relationships can become strained and distant when everyone knows there’s a skeleton(s) in the the closet that everyone is just sweeping under the rug. It is impossible to have healthy relationships with other people if you can’t trust them.

We work hard on a daily basis to overcome some of the negative patterns that have been ingrained in us since we were young children.

We decided we don’t want this path for our children. This is what led us to take our five-year-old to a martial arts studio that focuses on teaching love, respect (for self and others), and self control.

We did this for a multitude of reasons.

He is a sweet and smart boy. He gets stellar reports from school and is usually a good boy at home. However, he sometimes chooses not to listen to our requests which ends up in turmoil.

He has been a strong-willed child from day one…even in utero! This determination often gets him in trouble. It’s kind of like the idea of curiosity killed the cat… sometimes he just can’t help himself. The self control aspect of martial arts is one of the main reasons we chose this route for him.

We want him to know from a very young age that asking for help is completely normal and healthy. We know he won’t be perfect at this and will have to rely on others for guidance to learn.

My husband and I are aware that even though we are conscious of some of the negative patterns that we learned from our parents, they occasionally show up and our son has seen it. At such an impressionable age, we are hoping that if he picked up on any of these that they can be reversed now rather than him having less-than-ideal emotional reactions as an older child, teen, and adult.

It takes a village. We know we don’t have all of the answers and would like exposure and input from an impartial party that isn’t Mom or Dad that he can relate to, trust, and respect.

He tends to be a perfectionist and sees everything is very black and white (as toddler’s do). He doesn’t handle being corrected by us very well. For example, he went through a phase where he called the letters of the alphabet numbers. When we would try to explain to him that that wasn’t the case, he would get extremely angry and breakdown, as if we were accosting him. We want him to realize that it’s okay to be wrong, it’s okay to fail, and it’s okay to receive constructive criticism. The key is to always learn and grow from these experiences. (A wise and uber successful acquaintance of mine once told me that every night when he puts his children to bed he has them talk about three successes and one failure. He said he felt that the one failure was more important than the successes because it provided opportunities to learn, grow and improve which can be way more valuable than successes that come easy.)

We really want him to have a solid emotion base, self confidence, and resilience so he can avoid the issues of eczema, chronic disease, and autoimmunity that so many in our family have suffered from. Mostly, we want him to be a happy, kind, and well adjusted person because the world could use lots more of that.

The holidays are coming which means lots of things, good and bad. The good: time with family and friends, giving to others, good food, fun experiences, and great memories made. The bad: the stress of it all, family and friends, feeling pressures to keep up with the facade the media and business has perpetuated about the holidays, and good food.

I’m sure we could add more to both the good and the bad list, but did you notice things like family, friends and food showed up on both lists. This is because they can contribute to both extreme joy and health, but for some they’re stressful, traumatic and straight up unhealthy.

In fact, emotional turmoil can be more toxic than anything in the environment and wreak havoc on your gut and immune system. This is why there’s an uptick in cardiovascular events and strokes at this time of year. This is also the perfect scenario to catch a cold or the flu.

The best way to avoid this is to have a plan.

To avoid stresses try some of these tips:

Plan your budget and stick to it. Finances are one of the biggest stressors at this time of year.

Plan your meals. If you have eczema, gut issues, or autoimmunity, this is essential. Ask hosts in advance of plans and let them know you have special needs. Offer to bring a few dishes that work for you and you can share with others. Better yet, host a dinner or party yourself and show everyone that eating your way can be delicious (it’ll be your gift to them).

Say no to events that will cause you unnecessary stress. There is no rule that says you have to go to everything you’re invited to (this includes family). Politely decline and wish them a happy holiday.

Invite only who makes you happy… even if it’s your family member you’re excluding. I’ve gotten to the point where my health and the health of my family are more important than the feelings of a mean spirited family member, so we don’t invite them. We have a rule: you must play well with others. If you don’t, you’re not welcome. Some may feel this is harsh, but sometimes said family member learns a lesson and is nicer. Sometimes they don’t. They point is that you and your family aren’t victim to someone else emotional bullying or games.

Plan for down time, naps and rest. There’s a reason why nature slows down at this time of year and we should follow suit. Relaxation helps support a healthy immune system.

Have fun and laugh a lot! Again, great for your immune system and mental outlook.

Make sure you get enough sleep (most of the time, anyway). Holiday parties, shopping, and events can last late into the night, Pay attention to your body and listen when it says it’s time to shut down.

If you have kids, pay close attention to them. Sometimes the holidays are stressful for them, but they don’t tell us or have the words to convey it. It’s our job as parents to observe and look for signs such as acting out, behaving in an unusual way, or isolation to clue us in.

I hope you find some of the tips helpful in navigating the amazing, yet stressful time of year.

On the same note, check out the article on Addressing Emotions in Kids to Prevent Eczema and Autoimmunity. Emotional health and good emotional intelligence are essential to long term health. The foundation is set in childhood (even in utero) and has lifelong effects. Let’s help our children avoid the epidemic of chronic disease we’re seeing today.

Wishing you and yours a happy, healthy, and fun Thanksgiving!!!

**********************

Question of the month:

Q: How do I maintain my diet during the holidays and will it affect me if I cheat?

A: We hate to place labels or stigmatize food, but the truth is that sometimes dietary modification is necessary for healing. Even during the holidays (where it may be more important!).

For anyone that has ever worked with us, you know our philosophy is to only do necessary dietary restrictions for the shortest period of time and then expand the diet again. If this happens to occur during the holidays there are ways to navigate it.

Planning your food as mentioned above is key. This involves contacting hosts or even restaurants to find out what the menu offerings will be. Most restaurants now a days will accommodate dietary restrictions, especially if you will let them know in advance. And, contrary to what most people believe, most hosts are understanding as dietary needs as well. Some will go so far as to provide menu offerings that suit you (when I host a gathering I reach out to the invitees to find out if there are any dietary restrictions ahead of time). If they don’t do that, you can always offer to bring some dishes yourself to share to make sure you have something to eat.

Keep your home pantry stocked with foods that you can eat for impromptu gatherings. I also recommend making some food ahead and placing it in the freezer to avoid last-minute scrambling to make special dishes or “having” to eat something outside of your special diet.

Grocery stores are more frequently carrying gluten, dairy, nut, and soy free products making it easier for you to pick up something on the fly as well. Just be sure to read labels.

And the “cheating” conundrum…. First, I hate to use the word cheating because that implies you’re doing something wrong. Let’s be clear- while you’re definitely not doing something wrong, you may be doing something that does not promote health in your body at the time. For some, if you are on vacation or holiday, and you indulge in something that is not on your current menu, it may not affect you at all. For others however, that same indulgence may tip the scale toward an inflammatory cascade. So much of it depends on your stress levels and gut integrity. The more stressed out you are feeling, the more likely is that you’ll experience symptoms from eating foods that are potential triggers for you.

Try your best to avoid items that you know can cause issues. Remember that the holidays are a relatively short blip in time when compared to the rest of the year. They will soon be over and you’ll still be on your journey to vibrant health.

Understanding an eczema outbreak is really complex. And like a child learning language, you have to understand the alphabet and sounds first before you can talk. Same goes for eczema.

To really understand an eczema outbreak, you have to first understand the difference between the way functional medicine and conventional medicine views it.

Why Functional Medicine?

Functional medicine (FM) is a “systems” way of thinking. And when we say “systems,” it’s not like conventional medicine that views the body as a group of isolated systems where you have a cardiologist for the heart, an endocrinologist for hormones, etc. In FM, we view the systems, or areas of the body, as operating as a whole response to the environment (kind of like the operating system of a computer).

It makes perfect sense because each area influences the others.

A good analogy to help you understand functional medicine versus conventional medicine is to think about a tree. Visualize the entire tree with its roots, trunk, branches, and leaves. Conventional medicine looks at one branch, whereas functional medicine views all of the branches, trunk, and roots. It’s going to look at the leaves and even further in-depth because we really want to understand what’s going on in the entire person.

When we do this, we take a really detailed history and look for root causes. It’s interesting that we look for root causes and use the tree analogy, because the goal is to find out what is foundationally disrupted in your body to figure out what’s causing the eczema flare.

Conventional medicine really tends to see eczema as something that doesn’t truly have a cause yet. When I was told that I had eczema the doctor said, “You’ve got eczema. There’s no known cure. See you later.” However, in functional medicine—and now even in the medical literature (check it out here)—they’re starting to talk about it as an autoimmune condition and starting to identify some causes of it. And that’s what we’re going to get into here a little bit later.

This is why taking a FM approach to looking at eczema really can help you get down to why things are happening.

The ATM Model

One of the foundational principles of understanding functional medicine is the concept of antecedents, triggers and mediators. We call it the ATM model. These are how a functional medicine practitioner frames an understanding of your entire life history and contributing factors to your condition. We’re looking at all of that to figure out how you got to where you are today.

Let’s start off with the antecedents, which are the predisposing factors. Those are things like genetics and family history, lifestyle, past illness, and exposures (occupational, home, or environmental), and are the underlying or precipitating cause of illness.

A key point regarding genetics and family history is that they aren’t life sentences. A lot of people think, “Oh, there’s cancer in my family. I’m going to get cancer.” That’s not necessarily the case. There are so many modifiable factors here that can prevent you from actually having that illness even though you might be very prone to having it. Great news!!

To recap: Genetics are largely modifiable. NOT your destiny. **Note, in a future post I’ll address genetic concerns such as the filaggrin protein and common SNPs (single nucleotide polymorphisms) that matter to eczema suffers.

Triggers are what provoke the signs and symptoms of illness. Those are along the lines of infections, allergens, toxins, radiation, surgery, social conditions, and things of that nature. They’re going to combine with the antecedents to actually cause more signs and symptoms.

Last, the mediators perpetuate the illness. You can think about these on a biochemical or psychosocial level. Biochemically speaking, the hormones, neurotransmitters, metabolites, free radicals, and inflammatory chemicals are what perpetuate what’s going on. Once you have that genetic factors, plus the triggers, these mediators keep that cycle going. In the case of eczema, it’s going to cause the flare to continue.

The psychosocial factors—stress, thoughts, beliefs, community- are extraordinarily important in this model, but also in eczema. Stress is often the primary trigger and tipping point for most people (***remember stress can be emotional or physiological like trauma or infection…regardless of the source, it causes systemic biochemical changes that are bad if they continue for a prolonged period of time).

Eczema ATM’s

Genetics, family history, lifestyle, past illness, and environmental exposures are key antecedents for everyone. For example, if you have certain historical factors like a family history of autoimmunity or allergies, asthma, and eczema (the allergic triad) you’re much more likely to get eczema than the rest of the population.

The most common triggers I see in practice are infections, allergens, toxins, diet, and dysbiosis (an imbalance in the microorganisms in your body—not just in your gut, but all over your body). In eczema, skin dysbiosis can be an important piece of the puzzle too.

Depleted Nutrients. In practice it’s usually omega 3 fatty acids, vitamin D, antioxidants such as vitamin C and selenium, and minerals such as zinc and magnesium. Protein malabsorption can be an issue too since you need the amino acids to make collagen and skin tissue.

Inflammatory chemicals. Histamine, cytokines, and free radicals are major contributors here, though there’s a long list of players in this biochemical pool.

Impaired liver function. If you’re liver can’t function optimally, you can’t clear metabolic waste, toxins or hormones efficiently which are essential for a healthy gut and skin. This is often one of the key places we address first.

Leaky gut. This occurs when many of the above factors cause increased intestinal permeability allowing things into the bloodstream (like bacteria, toxins, proteins, etc.) that shouldn’t be there. This causes inflammation and immune system activation driving the eczema cycle.

I find for most of the clients we see in our virtual clinic is that stress is often the most significant factor, either as a trigger or as something that’s perpetuating, or both. We work on addressing it in its many forms, in many different ways.

To recap- if you’re having an eczema flare or a flare-up of any autoimmune condition- you’re looking at: antecedents + the triggers + the mediators= cause of flare.

It’s a cyclical process that self-perpetuates until you identify the triggers and the root causes to stop this cycle. You must eliminate the root cause imbalances such as infections, hormone and nutrient imbalances, allergens, foods, etc., to get this cycle to stop. Then you actually need to take the proper steps to heal it (replacing nutrients, healing leaky gut, balancing hormones, improving liver function, etc.).

Real Life Eczema Example

I’m going to use myself as an example. I’m not necessarily proud of this, but we’re all human 😉

I was driving home from my sister’s this past Halloween. I had just thought to myself that I was so excited because I didn’t have any Halloween candy…. but then I did.

BAD IDEA!

About an hour later, it triggered a flare. And for me, the area where my eczema always, always, always starts is my left wrist and my left hand. They started itching like mad. I was scratching for four hours.

UGH!!!

Immediately, I went downstairs and took some anti-inflammatory nutrients because I knew I had to get at that flare before it became a full-blown outbreak. Yes, it is possible to dampen the effect of a flare once you have your eczema under control.

But for me, I had a major flare. My last major flare was 1.5- 2 years ago. I hadn’t had anything go on since then until I was pregnant recently and had a few minor flares (due to hormones) that went away quickly.

Let’s also review my ATM’s.

My major antecedent is the allergic triad in myself and family members. As I mentioned above, the allergic triad is allergies, asthma and eczema. Most of that manifests in childhood, but not always. I only had allergies in childhood. Eczema started in my 30’s! If you have any of those, you’re also going to be more prone to autoimmunity as an adult.

And, eczema often accompanies other autoimmune conditions, not just in and of itself.

So I have 2 of the allergic triad, and a family history of autoimmunity and inflammation conditions. There’s lots of cardiovascular disease and diabetes in my family. Historically, I was bottle fed and was around smokers growing up which are also key antecedents in developing eczema.

My main trigger for this flare was hormone imbalance and dysbiosis that developed during pregnancy. In the gut, when your hormones such as progesterone are high, it slows things down in pregnancy. It sets the stage for things like leaky gut and dysbiosis to occur. This was something that I had experienced quite a bit of during my pregnancy (even though I tried my hardest to prevent it since I know what I know!!).

Diet was also a key trigger (especially the candy). I kept a clean, organic diet for the most part. However, after the birth, my diet has not been quite as tight. I’m gluten-free and try to be in the realm of Paleo/Autoimmune Paleo. But sometimes I have corn or dairy or beans. And those things have crept into my diet more frequently now that I’ve had the baby.

The candy just happened to be the breaking point for me… that little bit put me over the edge!

My primary mediators were hormone and nutrient imbalances from pregnancy and breastfeeding, leaky gut, and STRESS.

I’m going to reiterate stress here… I’ve got a new baby. I’ve got a 5 year old. I’ve got work. I’ve got life. Everybody’s got stress. But I currently feel like I have a lot on my plate. That’s the main mediator perpetuating the cycle for me.

And for me, stress is probably the number one factor that contributes to my flares every single time. When my stress levels get high, I can get a flare super easily. And I know that’s true for many of the people we work with in the clinic as well.

Another less obvious mediator is lack of sleep. Lack of sleep is a major contributor to manifesting any autoimmune condition, especially something like eczema. We heal and regenerate when we sleep. If you’re not sleeping well, it’s not happening.

Lastly, there’s the issue of support and community, or a lack thereof. When you first have a baby, everyone comes and sees you for the first couple of weeks. And then it’s suddenly, it’s gone. This can leave you with a sense of feeling like you’re lacking community or lacking support. I won’t say that I feel that tremendously, but I feel it a little bit.

All of these things added up and resulted in my eczema flare.

I got it under control by tightening up my diet, doing some keysupplementation, andtopical salves. Thankfully, this prevented it from erupting into a full-blown outbreak.

Chronic inflammation = disease. This is a profound statement that has broad ramifications for health and disease management everywhere.

If you look at the root causes of almost every single disease and death, you’ll notice that chronic inflammation is a player in the process.

Some inflammation is good—in fact, it’s a normal, healthy biological process. It’s only when inflammation goes unchecked for extended periods of time that it becomes a big problem.

Think of inflammation as a smoldering ember. If you have a few embers in one room of a 10-story building, it’s a small problem that’s contained. But if you have embers in every room on every floor of that 10-story building, now there’s a problem. Just a little puff of air might rekindle these embers into an actual fire again. Eventually, the heat from this small fire could grow, and the whole building could go up in flames.

This is similar to what happens in the body. A minor infection might cause a fire that turns into smoldering embers, and these embers die out when the infection is gone (if you have a healthy immune response).

If you’re stressed out, not exercising or sleeping well, or have poor nutrition, imbalanced hormones, and GI problems, there’s a good chance you have smoldering embers burning throughout your body, creating a low-level systemic fire.

If you don’t identify the causes of these small fires, they’ll wreak havoc on your body and cause full-blown diseases like diabetes, heart disease, cancer, Alzheimer’s, Parkinson’s, dementia, stroke, autoimmune conditions, or hundreds of other major diseases.

The good news is that the power to change this is in your hands, because every action you take each day either contributes to health or causes disease.

What Exactly is Inflammation?

Inflammation is a big buzzword in the world of health now, and rightfully so. The word inflammation comes from the latin word “inflammare,” meaning “to ignite,” and it’s your body’s response to danger signals.

Classically, inflammation describes the body’s immune response and biochemical processes to remove harmful stimuli, such as pathogens, toxins, irritants, or even damaged cells in an attempt to preserve itself and heal. Then we have the physical manifestations of inflammation: calor (heat), rubor (redness), dolor (pain), tumor (swelling), and loss of function.

This process is apparent when you have a cut on your arm, a bad sunburn, or a pimple. It’s less obvious when you have a viral or bacterial infection, since you can’t see the signs. What we’ve described here is acute inflammation. Acute inflammation is a normal process necessary for life; it allows you to survive scrapes and infections. It has a beginning and an end.

Conversely, chronic inflammation persists without end in response to hidden infections, toxins, chemicals, and/or foods or from lack of counter-regulatory mechanisms (chemical “off” switches) in the immune system that should turn inflammation off.2 Persistent cellular stress or dysfunction caused by a high calorie, low nutrient diet, oxidative stress, and hormone imbalances perpetuates this process.

Chronic inflammation is never a good thing. The major danger with chronic inflammation is that it’s silent, causing destruction for years or decades before it’s noticed (usually as the first signs of a disease), leaving significant damage in its wake.1 It could be raging inside you at this very moment without you even noticing. This kind of inflammation is what underlies almost every chronic illness and disease known to man.

Acute and chronic inflammation share a common origin, although they end with two very different products. The main differences between the two processes are:5

Acute Inflammation:

Elimination or isolation of the stressor (infection, toxin, chemical, etc.)

Destroys cells and tissue over time (like the degeneration of joints in arthritis)

Long duration (months to years)

Often unnoticeable or hidden

How Does Inflammation Occur?

The inflammatory process is a complex symphony of the response of the immune system and its interaction with many different types of cells and biochemical signals.

There are two main branches—the innate immune response, which occurs quickly and is more simple and nonspecific, and the acquired immune response, which occurs more slowly, as it’s more specific and has memory (so when you encounter the same trigger, such as a virus, your body is prepared for the attack).

Triggers, such as infection or injury, induce a series of biochemical events. Numerous substances are released simultaneously by the injured tissues, causing changes to the surrounding tissues.6

Remember our 10-story burning building? You can think of your injured tissue doing this just like you would turn on the sprinklers to dampen the fire and alert the fire department.

There are many chemical messengers that function in this process; however, the important ones to note are histamine, serotonin, bradykinin, lipid (fatty acid) derived mediators, cytokines, and acute phase reactants.

These chemicals are the “fire department,” with their many tools to put out the fire. They’re responsible for actions such as swelling (increased leakiness of the blood vessels), relaxation (dilation) or tightening (constriction) of the blood vessels, airways, and intestinal smooth muscle, and sending out chemical messages that turn on genes, recruit more helpers to the scene, or produce substances involved in the inflammatory process itself.

Histamine: Most people are aware that histamine is involved in the inflammatory response given the significant notoriety of antihistamines with allergies.

What many people are unaware of is that it also functions as an excitatory (stimulating) brain neurotransmitter producing wakefulness and anxiety, which is why many people with severe allergies, hives, or GI infections don’t sleep well.5,6 Its highest concentrations are in the gut, skin, lungs, and central nervous system (CNS), where many of the symptoms are felt.

Serotonin: This substance is best known as a brain neurotransmitter responsible for keeping you happy, calm, and well-rested. It’s also known for its role in the gut, affecting motility (how food and waste move through) and secretion of digestive chemicals. 95% is produced in the gut, and it can be significant in inflammatory GI disorders. You know that feeling when you get butterflies in your stomach, then have anxiety and maybe diarrhea? That’s serotonin. Together, histamine and serotonin are some of the first responders in the inflammatory movement.3,5

Bradykinin: This protein isn’t well-known by name; however, you’ve felt its effects many times before, since it’s a significant chemical in the inflammatory process. Bradykinin causes many of the actions of the inflammatory process (swelling, pain, blood vessel dilation, etc.) itself, or it signals other cells to participate and release their chemicals. It can also increase histamine release, making a response more intense.4 Bradykinin is most often released from tissue damage or exercise.4

Lipid Derived Inflammatory Mediators: This is a fancy term for chemicals derived from the oxidation (the loss of electrons from molecules—think rust) of the omega-6 fatty acid, arachidonic acid (AA), and omega-3 fatty acids’ eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Like histamine, you may have heard of some members of this group of chemicals before, since prostaglandins and leukotrienes are called out in the inflammatory process in advertisements.

They’re short-lived, signaling molecules found in most cells that modulate all aspects of the inflammatory process, including the resolution of inflammation, and they have system-wide influence on nerve transmission, mood, and hormone secretion.5,7,8

Cytokines: These are the primary chemical switches that turn the immune response on and off. They activate and recruit other cells to the immune response and assist in antibody production. Cytokines are responsible for fever production and participate in the allergic response, as well as antimicrobial and antiviral activity.5,7,8

Tumor necrosis factor alpha (TNFɑ) is one of the most important cytokines involved in systemic inflammation; it regulates other cells of the immune response. It has antiviral and anti-tumor activity, and dysregulation is implicated in obesity, Alzheimer’s, cancers, depression, and IBD.5,7,8

Acute Phase Reactants (APR): APRs are a category of proteins produced in the liver that increase or decrease in response to inflammation. Some of the most notable are C-reactive protein (CRP), ferritin, and fibrinogen.

CRP increases rapidly with inflammation and marks damaged cells, making them easier to identify for elimination. Once it rises, it’s cleared rapidly from the system.11,12

Ferritin, an iron carrier protein, increases in response to most infections, except a few bacterial strains.11,12 Fibrinogen is a coagulation factor promoting clot formation that increases with inflammation. ESR (erythrocyte sedimentation rate), also considered to be an APR, describes the rate at which red blood cells fall in a one-hour period and correlates to fibrinogen levels.11,12

Other aspects of the inflammatory response involve the formation of antibodies to specific antigens and the blood clotting system. Antigens are proteins found on all cell surfaces, and when the immune system identifies them as foreign, it forms a corresponding antibody to it. Antibodies either neutralize the foreign invader or prepare it for phagocytosis (engulfing of a foreign particle for elimination).9

The process of blood clotting (coagulation) involves a group of proteins that convert clotting factors (such as prothrombin, thrombin, and fibrinogen) to a fibrin clot. The pathway is linked to inflammation since the clotting process, which occurs outside of a cell, can trigger the inflammatory signaling inside of a cell.

These processes operate in a feedback loop that promotes one another, and when left uncontrolled, this loop can be a problem in chronic inflammation—especially cardiovascular disease, clotting disorders, and hormone imbalances.10

All of these chemicals signal in various ways to elicit the response that produces redness, swelling, heat, immobility, and pain—as they should—but the body is smart and knows that the inflammation must end.

Dr. Robert Rountree, MD, states, “Simultaneously, the body activates biochemical counter-regulatory pathways (off switches) that produce anti-inflammatory mediators such as lipoxins, protectins, and resolvins. These are lipid mediators that are made on demand from the omega-6 fatty acid, arachidonic acid (AA), and the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) specifically for the purpose of turning off the inflammatory response.”2

This pro- and anti-inflammatory balance is the adaptive immune process, and it’s what should happen after an acute injury where the body identifies and responds to the insult or invasion, then repairs the injury and the process ends.

This process becomes a problem in two scenarios. First, when this response is exaggerated, producing a severe allergy or anaphylaxis. Second, when the cause of acute inflammation persists without end or the counter-regulatory mechanisms (anti-inflammatories) are compromised, producing chronic inflammation. Acute inflammation from a wound, infection, or a food allergy will cause systemic, chronic inflammation if not identified and treated.

Additionally, when the normal mechanisms that quench inflammation are decreased (or pro-inflammatory processes are increased), chronic inflammation will ensue. Inflammation begets inflammation, so it’s important to identify the triggers to stop perpetuating the cycle.

Functional medicine cardiologist Dr. Mark Houston says it best: “The body has a limited number of options to deal with an unlimited number of insults.”

Triggers of Inflammation

There are many triggers of inflammation, and often several are operating in concert together, propelling the cycle forward.

What these triggers have in common is that they generate free radicals or reactive species from oxidative stress and/or the inflammatory chemicals discussed previously.

Free radicals and other reactive species are produced as a product of oxidation, which involves the removal of one electron from an atom, rendering it unstable or reactive.

Your body obtains energy by combining fuel from the foods we eat with the oxygen we breathe in a controlled metabolic process that yields potentially dangerous oxidative byproducts that damage DNA, mitochondria, proteins, and cell membranes if we don’t have the appropriate antioxidant and anti-inflammatory mechanisms in place.

Oxidative stress isn’t only generated when you eat, but also during exercise, detoxification, and when the immune system is activated in the inflammatory response.

The good news is that many of these triggers are modifiable lifestyle factors or conditions that can be tested for, identified, and reversed. Dr. Mark Hyman, MD explains the importance of identifying the causes, explaining, “My job is to find those inflammatory factors unique to each person—to see how various lifestyle, environment, and infectious factors spin the immune system out of control, leading to a host of chronic illnesses.”16

The most common triggers are:

Diet

Stress

Dysbiosis

Infection

Hormone imbalance

Toxins

Trigger: Diet

Diet, for most people, is the single most important lifestyle change that can significantly impact chronic inflammation.

The food you eat sends chemical messages to your genes, which will either turn up or turn down inflammation. The following are pro-inflammatory foods (so you should think about avoiding them):

Gluten: A protein that has been hybridized (changed from its original form through breeding, not genetic modification) to the point that your body sees it as foreign and reacts to it. This reaction upregulates the immune system and will continue until the gluten is removed.

Food Sensitivities and Allergies: Gluten, dairy, corn, soy, yeast, eggs, and nuts are the most common offenders. When your body is constantly bombarded by these irritants, leaky gut, or increased intestinal permeability occurs, allowing larger food particles to enter your blood, and the immune system responds. Since you eat several times a day, the result can be a continuous cycle of inflammation and immune upregulation until the source is eliminated.

GMOs: Genetically modified foods that your body can’t identify can trigger an immune response similar to a food sensitivity. The largest GMO crops are corn, canola, soy, sugar beets, zucchini, yellow squash, and papaya, many of which are pro-inflammatory to begin with.

According to Dr. Tom O’Bryan, BT (botulinum toxin) in GMO foods has been shown to cause severe intestinal permeability in insects.23 Dr. O’Bryan also warns that BT toxins have been found in maternal and fetal blood, so we know they’re getting absorbed when we consume them.23

Sugar and Refined Carbohydrates: Your body is only designed to handle small amounts of natural sugar, and there are several issues with exceeding this amount.

First, refined sugar and carbs are genetically unfamiliar, which is a problem.11 Second, when you consume sugar or carbs, especially in large amounts frequently, it causes a rapid rise in blood sugar. If you need fuel, your body will use it; otherwise, it gets stored in muscles as glycogen or in fat cells.

If you have decreased insulin sensitivity or diabetes, this storage process is inefficient, leaving sugars in circulation, which spells trouble because it leads to the formation of free radicals from increased oxidation. Too much insulin release is pro-inflammatory as well.11 Excess sugar also promotes yeast overgrowth and dysbiosis (higher amounts of bad bacteria versus good bacteria), which further encourage inflammation.

Conventional Dairy and Meats: Meat and dairy raised in a conventional manner (grain-fed versus grass-fed) have the same health problems humans do, since they weren’t meant to eat grain.

Consuming all of these grains leads to a higher production of pro-inflammatory omega-6s and fewer omega-3s in these animals. When you eat them, you’re increasing your levels of pro-inflammatory fats as well. Some of the proteins (especially A1 casein) found in dairy are known to promote inflammation according to Dr. Kelly Brogan.13

Bad Fats: Most Americans have a dietary (and bodily) imbalance in their omega-6/omega-3 ratio, which causes your body to be in a pro-inflammatory state. Corn, safflower, sunflower, soy, and peanut oil are all omega-6s. Also, healthy fats such as olive oil, nuts, and nut oils are degraded (oxidized) when used in cooking at high heats or when storing them improperly, leaving them vulnerable to oxidation due to air exposure.

Processed Foods: These foods contain additives, colorings, dyes, and preservatives that your body sees as irritants or toxins. Because these foods are foreign to your body, they may induce an immune response.

Advanced Glycation End-Products (AGEs): AGEs are produced as a result of a glycation reaction, when a sugar reacts with a protein or fat. AGEs form stable molecules that embed in tissues, causing oxidative damage, and are difficult for the body to get rid of. In food, they occur by cooking at high heat as with grilling, barbecuing, deep frying, broiling, and searing—basically anything that gives color or texture. The higher the heat, the more AGEs that form.

Meats, sugary foods, and processed foods are particularly high in AGEs. They also occur naturally in your body, and the higher your blood sugar, the more these will form, so limiting sugars and maintaining blood sugar is important. Fructose is particularly reactive, so limiting daily intake to 25 g or less is best.15

Stress as a trigger for inflammation is just as important as diet is. It could be argued that stress is more so, actually, since stress comes in so many different forms that all add up when combined in our hectic modern lives.

Emotional Stress: Work, finances, relationships, job change, marital change, death of a loved one, birth of a child, etc. This is what people commonly refer to as “stress” in their lives. These stressors are often the hardest to control and can have a profound impact on healing.

It’s important to note that the body doesn’t discern between different types of stresses. Similarly, it can’t perceive the difference between good stress (birth of a baby or a new job) and bad stress (loss of job, divorce) and will react the same.

Anything that disrupts homeostasis will be perceived by the body as a stressor, and it will act accordingly in an effort to keep you alive.

Stress, like inflammation, is good when the response is appropriate and controlled. It initiates the ‘fight or flight’ response meant to keep you alive when danger is present (like when you encounter a bear and need to escape), like blood rushing to your brain to keep you focused. Simultaneously, non-essential functions like digestion and reproduction are decreased.

Just like with inflammation, counter-regulatory off switches exist so that the stress response ends. This was great in paleolithic times; however, in modern life, we have an overabundance of stress that doesn’t seem to stop.

Our stress response never ends, disrupting the mechanisms that should bring us back in balance. This causes several physiological changes that potentiate inflammation.

Chronic stress causes the sympathetic nervous system to be upregulated and increases levels of the stress hormone cortisol.

Over time, constant cortisol elevation leads to cortisol resistance, where the body must pump out even more to meet the same metabolic demands.

When this occurs for extended periods of time, cortisol levels become chronically low and adrenal fatigue develops. Cells of the immune system become insensitive to cortisol’s regulatory effect and don’t respond, which promotes inflammation.17

Not only does stress promote inflammation, but it also lowers immunity. A 2012 study by Dr. Sheldon Cohen revealed that prolonged exposure to a stressful event was associated with the inability of immune cells to respond to hormonal signals that normally regulate inflammation.

In turn, those with the inability to regulate the inflammatory response were more likely to develop colds when exposed to the virus. “The immune system’s ability to regulate inflammation predicts who will develop a cold, but more importantly it provides an explanation of how stress can promote disease,” Cohen said. “When under stress, cells of the immune system are unable to respond to hormonal control, and consequently, produce levels of inflammation that promote disease. Because inflammation plays a role in many diseases such as cardiovascular, asthma, and autoimmune disorders, this model suggests why stress impacts them as well.”17

Dysbiosis occurs when there’s an imbalance between the beneficial and harmful organisms in you body, especially the gut.

Normally, you have helpful bacteria and even some yeast that help you digest food, produce nutrients, and protect you from harmful organisms as well as inflammation.

Dysbiosis arises when there’s a general imbalance between the good and bad flora, or when there’s a pathogen or infection present, such as SIBO (small intestinal bacterial overgrowth), Candida (yeast), or a parasite.

Additionally, an increase of certain gram-negative bacterial species promotes inflammation because most of them contain lipopolysaccharide (LPS) in their outer cell membrane. This is an endotoxin—as the name suggests, that’s bad because it promotes inflammation by eliciting a strong immune response and contributing to leaky gut (increased intestinal permeability).

SIBO arises when there are more bacteria in the small intestines than there should be. Normally, there are much fewer bacteria in the small intestines than the colon since the small intestines function more in digestion and absorption of nutrients. SIBO infections can promote inflammation through the imbalance of bacteria, leaky gut, nutrient malabsorption, and the imbalance of histamine and serotonin.

Candida (yeast) is a fungus that aids in digestion and nutrient absorption. It’s opportunistic, becoming pathogenic and increasing in numbers if your immune system is compromised from stress or illness, or if your diet is high in sugar and carbohydrates.

Research shows that Candida infection delays healing, and the inflammation from the infection promotes further colonization of yeast, creating a vicious cycle of low-level inflammation and infection.19

Parasites are literally everywhere. Giardia (sometimes called beaver fever) and Cryptosporidium are some of the parasites that make the headlines occasionally, even though there are a plethora that exist. Acute parasitic illness manifests with the typical symptoms of diarrhea, vomiting, stomach pain, bloating, fever, and malaise. Most resolve with the normal immune response.

Chronic infections, however, can range from asymptomatic to severe, with blood and mucus-filled stools, profuse diarrhea, and malnutrition. These infections contribute to inflammation through decreased nutrient absorption, constant immune system attack, and interrupted sleep patterns.

Trigger: Infections

Infections other than typical GI infections are also a common source of inflammation; they often go undetected for long periods of time, allowing them to wreak havoc on the body and the immune system.

Some more obvious infectious agents are mold (fungal infection), Lyme and other tick-borne illnesses, and chronic viral infections like the Epstein-Barr virus (EBV). Less obvious and often hidden infections that can go undetected for years are abscesses from trauma or surgery, but especially dental procedures.

Mold: Describes a group of fungi that are ubiquitous. Their spores are often airborne and deposit everywhere, which is why you find white or green fuzzy patches on your produce or bread. It can be associated with dysbiosis or systemic infection.

The toxins (mycotoxins) that come from mold are very harmful, producing symptoms ranging from mild to severe fatigue, sore throats, nosebleeds, headaches, diarrhea, brain fog, food sensitivities, and memory loss. These symptoms often mimic other conditions, which delays diagnosis and allows inflammation to proliferate.

Tick-Borne Illness: Tick-borne illnesses are becoming more prevalent and are often hard to diagnose. Lyme disease, an infection acquired through the bite of a tick infected with the bacteria Borrelia burgdorferi, is the most well-known of this type of infection. Babesia, Rickettsia (Rocky Mountain Spotted Fever), Ehrlichia, and Bartonella are also frequently identified infectious bacteria from tick bites. These infections not only take a toll only the immune system itself, but also the gut, contributing to decreased GI motility and dysbiosis.

Chronic Viral Infection: A common but not often talked about cause of systemic inflammation. The problem with viruses is that they can remain latent (inactive) for extended periods of time and don’t reactivate until there’s a trigger.

Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are two herpes family viruses that can remain latent after initial infection and only become active again under stress or immunosuppression. EBV, the infectious agent in mononucleosis, is also associated with the development of several types of cancer and autoimmune conditions. Chronic activation of the immune system produces inflammation with undetected viruses.

Abscesses: Can occur after any type of tissue injury such as trauma, surgery, infection, or dental procedures (especially a root canal). They form when incomplete healing takes place, either from a physical barrier or because the body can’t mount an appropriate immune response to kill off the bacteria.

The constant activation of the immune system produces chronic inflammation, and many systemic symptoms can go on for years—this is one of the most difficult causes to detect, since most people forget about a procedure or discount an injury.

Trigger: Hormone Imbalances

Hormones need to be maintained in a delicate balance for proper function. When any hormone is too high or too low, many of the other hormones shift as well, causing imbalances throughout the system.

Cortisol, DHEA, insulin, estrogen, progesterone, and testosterone all have effects on each other, as well as other hormones, which all impact inflammation.

Generally, androgens (testosterone and DHEA) have a suppressive effect on the immune response and inflammation while estrogens increase the immune response. Research suggests:

“Low levels of androgens as well as lower androgen/estrogen ratios have been detected in body fluids (blood, synovial fluid, saliva) of both male and female rheumatoid arthritis patients, supporting the possibility of a pathogenic role for the decreased levels of the immune-suppressive androgens.

“Several physiological, pathological, and therapeutic conditions may change the sex hormone milieu and/or peripheral conversion, including the menstrual cycle, pregnancy, the postpartum period, menopause, chronic stress, and inflammatory cytokines, as well as use of corticosteroids, oral contraceptives, and steroid hormonal replacements, inducing altered androgen/estrogen ratios and related effects. Therefore, sex hormone balance is still a crucial factor in the regulation of immune and inflammatory responses.”

Adrenal fatigue with lowered cortisol and DHEA, estrogen dominance in women (with a relative low progesterone level), and low testosterone in men (with a relative elevation in estrogen) all create an imbalance that skews the body to a pro-inflammatory state. This state can be further exacerbated by poor blood sugar regulation.

Proper blood sugar regulation is critical in maintaining hormone and inflammatory balance. Excessive insulin is pro-inflammatory, as is the activity of the enzyme aromatase, which is increased by insulin.

Aromatase is the enzyme that converts androgens to estrogens, and it has a great deal of influence on the production and balance of sex hormones. Many cell types have aromatase activity, but adipocytes (fat cells) are of particular interest because the more you have, the more active aromatase is.

Toxins are virtually all around us in modern life, from pollutants in the air we breathe, the water we drink and bathe in, and the foods we consume to the products we use to clean ourselves, our homes, and our possessions. They can also be produced in the cooking process and in our guts.

The thyroid is particularly sensitive to chemicals and oxidative stress. With increased exposure, thyroid function decreases, producing a hypothyroid state that triggers weight gain and supports inflammation.

Toxins you’ll want to minimize exposure to include heavy metals (mercury, lead, aluminum, arsenic, cadmium, etc), tobacco smoke, air pollution outside and in the home, pesticides (organophosphates), herbicides, plastics (BPA, BPF, BPS, phthalates, polystyrene, PVC, etc.), chemicals (toluene, xylene), and preservative and chemical-laden personal care products and foods. This list is a good place to start, but it’s not exhaustive.

Anything that ends in ‘itis’ means that it’s inflamed. Appendicitis literally translates to “inflammation of the appendix.” Other than the obvious ‘itis’ conditions, here are other symptoms associated with chronic inflammation:

The treatment of inflammation can seem daunting since there are so many different causes.

The easiest approach is to clean up the diet, add in nutrients and make lifestyle modifications.

If you’re not getting the desired results, do some further investigating into root causes such as food allergies, autoimmunity, GI infections, impaired detoxification, toxic exposures (mycotoxins, heavy metals, chemicals), hidden infections such as Lyme or EBV, and proper hormone balance.

As Dr. Josh Axe notes, “Antioxidants are self-sacrificing soldiers that donate an electron to neutralize free radicals and are consumed in the process.” He suggests eating brightly-colored vegetables and fruits, cocoa, and green or white tea.25

Dr. Hyman also recommends getting an oil change. “Eat healthy fats from olive oil, nuts, avocados, and omega-3 fats from small fish like sardines, herring, sable, and wild salmon.”27 These fats are anti-inflammatory and promote a healthy omega 3:6 ratio.

An elimination diet may help you find out if there are foods contributing to your inflammation. Eliminate these foods for at least 30 days and note how they make you feel when you add them back in.

Cooking your foods at a lower heat will help them retain nutrients and avoid forming harmful substances. Author Mark Sisson recommends poaching, boiling, steaming, braising, baking, or using a pressure cooker or crock pot.28 If you really want to grill or cook at high heat, marinating with olive oil, citrus, and herbs or spices will reduce toxin formation.

Nutrients and Supplements: There are many anti-inflammatory nutrients found in fruits, vegetables, teas, coffee, herbs, and spices. Here are some that can be helpful if you experience inflammation:

According to neurologist Dr. David Perlmutter, turmeric (curcumin), green tea extract, pterostilbene (from resveratrol), glucoraphanin (from broccoli), and coffee activate an important anti-inflammatory pathway (Nrf2), and taking these nutrients as supplements can be far more effective at increasing antioxidant production than typical antioxidants.26

Lifestyle Modifications: These are some of these easiest and most effective ways to reduce inflammation. Incorporating them into your life as habits will help promote long-term inflammation management.

Stress reduction: Stress is one of the biggest contributors to chronic inflammation, and managing it essential to lifelong health. Identifying stressors is the first step. Once you’ve done this, create boundaries, say “no” when you have to, and make sure your feelings are heard and understood.

Sleep: Getting adequate sleep is essential to healing. Aim for a minimum of 8 to 9 hours per night, and try to get to bed by 10 PM. Sleep in a dark, cool, and quiet room for the most restful results.

Unplug: Being constantly tuned in to your phone, computer, iPad, tablet, or TV exposes you to radiation and can also alter your sleep cycle due to blue light stimulation.

Detox your personal care products: If you won’t eat it, don’t put it on your body. Opt for natural or organic lotions and creams, shampoo, conditioner, toothpaste, deodorant, and fragrance. You can make many for low cost at home from coconut oil, essential oils, and other common household items.

Detox your home: Look for natural and organic products here too to avoid toxic chemicals. Many cleaners are now being made from enzymes and plant soaps. You can also make homemade ones from vinegar, lemon juice, baking soda, essential oils, and more. Keeping lots of green plants in the home helps detox the indoor air as well. Look for rubber plants, aloe, peace lilies, areca palm, golden pothos, and English ivy.

With a little detective work and some requisite effort, you could be well on your way to putting out the fire from within your own body that’s robbing you of your health. Learn to listen to your body and to notice the obvious signs. Your body is an incredible machine that’s designed to want to heal. All it asks of you is to provide it with an environment that’s conducive to this objective.

Most micronutrients, such as vitamins, minerals, amino acids, and fatty acids, don’t get much notoriety (except for vitamin D and omega-3 fatty acids), but they should. These nutrients are the building blocks of every single process in your body, and without them, disease and dysfunction ensue.

Scurvy is a great example. Lack of vitamin C in the diet of British sailors during the 18th century caused bleeding gums and mucous membranes, poor wound healing, and spots on the skin. If left untreated, they would die from blood loss.

Vitamin C is essential for the formation of collagen in hair, skin, and nails, blood clotting, nerve and muscle function, and is an important co-factor in many biochemical reactions.

We take for granted that getting the correct balance of nutrients is required for maintaining good health. Even a small deficiency in one nutrient can have major consequences in the long run. Conditions ranging from acne to heart disease start with some type of nutrient deficiency or excess.

The symptoms are seemingly limitless, since almost every symptom has a nutrient component. So understanding the important ones is crucial to good health.

When considering the possibility of nutrient imbalances, people often start by assessing symptoms and trying to guess which individual nutrients might be associated with them. This is a less efficient way to do things, as you might miss important nutrients.

For instance, if you have neuropathy or tingling in your legs, you might look at vitamins B6 or B12, since they’re important for nerve function. But if the underlying cause is high blood sugar, you’d also want to know your magnesium, zinc, chromium, inositol, carnitine, lipoic acid, biotin, and vitamin B3, C, D, and E levels as well to have a more complete picture and treatment plan.

Since symptoms of nutrient deficiency and excess are vast, starting with a test that looks at many nutrients in an expansive panel is often a better way to go. The panels available now allow you to check multiple nutrients simultaneously, giving you greater knowledge of your body and the ability to rebalance nutrient levels properly.

Balancing nutrients appropriately is crucial, since too much of one and not enough of another can cause further trouble.

Nutrient Tests

There are many different types of test panels you could choose for analyzing your nutrient status. Depending upon your symptoms, condition, and health goals, you may want to select a smaller panel.

Or, if you’re unsure, a more expansive panel that looks at everything is a good choice.

Nutrient Panels:

Organic acid testing

Amino acid testing

Fatty acid testing

Combination nutrient testing

Organic Acid Testing

Organic acids (OA) are the end products (metabolites) generated by your metabolic processes,and they are easy to measure in urine. Organic acid testing provides an indirect way of measuring nutrient status, since all of your metabolic processes require certain vitamins, minerals, amino acids, and other micronutrients to function properly. It you are deficient in specific nutrients, it will show up as increased or decreased metabolites in the urine.

Nutrient deficiencies have several effects on metabolic reactions. First, serious deficits will impede biochemical reactions from occurring at all, giving a result that is below test detection limits.

Deficiencies can also cause a reaction to be limited/inefficient—producing low levels of metabolites—or cause a backup (think log jam) because there isn’t enough nutrient cofactor to propel the reaction forward. This results in an excess level of metabolites in urine.

Dysbiosis markers indicate the need for glycine, glutamine, and an amino acid complex.

Organic acids testing is available from Genova Diagnostics and Great Plains Laboratory.

Amino Acid Testing

Amino acids are the building blocks of proteins. When you eat protein, your body breaks it down into usable units, or amino acids, that are vital to life.

Non-essential amino acids can be made in your body, but some must be obtained through the diet. These are called essential amino acids. As individual amino acids, or linked as chains called peptides, they have many functions:

Amino acids can be assessed in the urine or blood. Genova Diagnostics, Doctor’s Data, and Great Plains Laboratory offer amino acid testing.

Fatty Acid Testing

Fatty acids are the technical term for what we typically think of as “fat.” For example, fish oil is comprised of the omega-3 fatty acids EPA and DHA. Like amino acids, fatty acids can be essential or nonessential, and they play a critical role in sustaining life.

Having the proper balance of omega-3, 6, and 9 (polyunsaturated, monounsaturated, and saturated fats) is critical for maintaining health. Among other things, fatty acids:

Several companies offer comprehensive test panels that allow you to see nutrients, amino acids, fatty acids, and organic acids in different combinations, depending upon your needs.

Great Plains Laboratories can provide many different panels based on your condition or health goals. Basic and comprehensive panels for autism, ADD/ADHD, fibromyalgia, Tourette’s, mental health, and wellness options are available.

Bacteria and your microbiome are an integral part of who you are—think of yourself as a bacterial hotel.

In fact, the bacteria living in and on your body outnumber your body cells by 10 times!

While there are 10 trillion cells in your body, there are 100 trillion bacteria that comprise an estimated 400-1,000 different species that coexist within you.2

The vast majority of them reside within your GI tract, weighing in at about 3-4 pounds.2,3,6

These bacteria have coexisted with us for millennia and are beneficial, helping us thrive by assisting in digesting and absorbing foods, producing vitamins and short-chain fatty acids, killing potential pathogens, maintaining a healthy weight, and supporting detoxification, inflammatory, immune, and hormone functions.6

The good bacteria and even a small amount of yeast are vital to your survival. Studies show that people with poor bacterial colonization after c-section birth and/or lack of breastfeeding have more health problems.3

While most of these organisms are helpful and essential, some are harmful and cause significant damage to the delicate balance of the ecosystem that exists in your gut.

What Exactly is Dysbiosis and How Does it Occur?

Dysbiosis occurs when harmful organisms, such as bacteria, fungi (yeast and mold), viruses, and parasites take over the gut environment and change your physiology such that it favors their survival (and that of other pathogens) to the detriment of your health.

What constitutes a healthy microbiome is constantly being redefined as more research is done. Recent research suggests that we may need to consider viruses, in addition to bacteria, as part of our commensal microbiome. “There have been suggestions that every individual harbors approximately 8-12 chronic viral infections at any given time, and these may be harmful only in the limited percentage of the population that has a certain genetic predisposition.”

The good bacteria collectively act as the Chief Operating Officer in your gut, keeping vital day-to-day functions occurring effortlessly without you even knowing it.

They help maintain immune and hormone function, modulate inflammation, protect you from pathogens, and metabolize and produce nutrients.

The primary reason this harmonious equilibrium of organisms can be maintained is that there’s a system of checks and balances so that one group can’t take control; however, when this balance is disrupted by stress, diet, medications, or toxins, dysbiosis is the result.

Dr. Leo Galland, M.D. simply states, “Dysbiosis is an unfavorable imbalance of the bacteria resulting in an intestinal flora that has harmful effects. The principal factors that regulate the composition and distribution of the GI flora are diet, motility, the nature of GI secretions, immune function, and the ingestion of antibiotic or probiotic substances.”8

Over time, the change in the intestinal ecosystem causes considerable chronic local and systemic effects. Dr. Gerard Mullin, M.D. asserts that, “Dysbiosis is not so much about the microbe as it’s about the effect of that microbe on a susceptible host; it’s about the relationship between the host and the microbe.”14

For example, people with inflammatory or autoimmune conditions often present with a pathogenic inflammatory response to a non-inflammatory microbe due to the activation of the immune system and the inflammatory chemicals produced in that interaction.12

If it’s caught and reversed quickly, you may not have too many ill effects. However, if this condition is allowed to progress, it can lead to serious health problems ranging from gas, diarrhea, constipation, and acne to joint pain, chronic fatigue, and autoimmunity.

Further, intestinal dysbiosis can lead to dysbiosis of other mucosal areas such as the mouth, nose, lungs, skin, eyes, and vaginal and urinary tracts, making you more vulnerable to other infections.

Triggers of Dysbiosis

Triggers for the development of dysbiosis are usually multiple and cumulative—meaning that the more you experience these as a part of your lifestyle, the more likely you are not only to have dysbiosis but also to have many of the symptoms associated with it. The main primary contributors to dysbiosis are:

Poor bacterial colonization

Medications

Stress

Diet

Environmental toxins

Infections

Trigger of Dysbiosis: Poor Colonization

The first step toward dysbiosis can actually occur during your birth. The process of vaginal birth naturally initiates the critical event of bacterial colonization.

Infants born this way have a microbiota that reflects their mother’s fecal and vaginal flora, where those born via cesarean section have a flora reflective of the hospital environment and the health care workers.3,12

Children born through c-section are also at risk of delayed access to breast milk, which can be an additional detriment to the development of a healthy flora.3

Research by Giacomo Biasucci et al. in the September 2008 issue of the Journal of Nutrition showed that the gut microbiota after c-section was characterized by a lack of Bifidobacteria species, which are thought to be important to the postnatal development of the immune system, whereas vaginally delivered neonates showed a predominance of these species.3,12

It’s also important that women who want to conceive are aware of the health of their intestinal flora, as infants born to women with dysbiosis also have dysbiosis. Taking care of GI infections and imbalances, as well as supplementing with specific probiotics, will help impart a healthy flora to the baby.

Trigger of Dysbiosis: Medications

Several categories of medications can directly impact the health of the GI flora. The most significant ones include:

Antibiotics: This class of medications is the most common and significant cause of major alterations in normal GI tract flora.6

Depending upon the scope of antimicrobial activity, antibiotics can wipe out multiple categories of beneficial organisms, leading to dysbiosis—the antibiotics don’t differentiate between the good guys and bad guys

PPIs: Proton pump inhibitors that block stomach acid (HCl) production provide a gateway for dysbiosis to develop, as HCl is critical to the normal process of digestion and acts as defense against pathogens. PPIs are known to directly alter the gut flora as well.

NSAIDs: Chronic use of nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen sodium, aspirin, and indomethacin can inhibit the growth of good bacteria and alter the gut flora, resulting in leaky gut, which further perpetuates dysbiosis.

Hormone-Based Medications: According to Gut and Psychology Syndrome author Dr. Natasha Campbell- McBride, M.D., “The use of birth control pills and immune system-altering steroidal hormones change the gut flora by harming the beneficial bacteria.” Widespread use of hormone-based medication isn’t often mentioned yet is a significant contributor to dysbiosis.

Trigger of Dysbiosis: Stress

Stress is one of the most important triggers of dysbiosis, as it’s something most of us have plenty of in our lives, and we don’t do much to counterbalance its effects.

Further, chronic stress diminishes immunity by depleting the antibody secretory IgA (sIgA), as well as essential hormones, and promotes inflammation, which can all result in a leaky gut.6,14

The catecholamine hormones (adrenaline and noradrenaline) stimulate growth of gram-negative organisms such as E.coli, Yersinia, and Pseudomonas, which promote inflammation and immune system activation by producing the endotoxin LPS (lipopolysaccharide).3,6,14

Many of these gram-negative bacteria are normal inhabitants of the large intestine; however, when the good flora are diminished, they can’t keep growth of these opportunistic organisms in check. This leads to dysbiosis and inflammation.

All of this culminates in a vicious, self-perpetuating cycle when you’re chronically stressed.

Trigger of Dysbiosis: Diet

Diet, along with stress, exerts the most impact on the balance and health of the gut flora.

Sulfates: Consumption of foods high in sulfates promotes the growth of bacteria that produce a toxic gas called hydrogen sulfide (think stinky egg smell), which results in depletion of colonic nutrients and leaky gut. Foods high in sulfates include eggs, cruciferous vegetables, dairy, dried fruit, alcohol, meat, baked goods, and processed foods.6

High Protein: Excessive consumption of protein, especially in the presence of enzyme deficiency, allows bacteria to ferment the undigested protein particles and produce toxic metabolites such as ammonia, indoles, phenols, and sulfides, which are carcinogenic and promote migraines and mood disorders.6,7 High protein diets can also promote inflammation and hormone imbalance through the action of some bacterial enzymes such as beta-glucuronidase.6,7

High Sugar and Carbohydrates: Diets high in sugars and simple carbohydrates are characterized by increased bacterial fermentation and decreased intestinal transit speed, allowing for toxic metabolites to sit in the intestines longer and potentiate inflammation.6,7

Bad Fats: Eating a diet high in trans fats and certain chemically processed or genetically modified fats inhibits the growth of protective bacteria.7 These fats include any trans fat labeled “partially hydrogenated,” shortening and margarine, as well as oils including canola, corn, soybean, peanut, sunflower, and safflower.

Processed Foods: Preservatives, dyes, emulsifiers, surfactants, additives, and flavoring all negatively impact the health of the gut flora, as they’re toxins. When you read a label, generally if you can’t pronounce it or don’t know what it is, you shouldn’t eat it.

Food sensitivities and allergies represent a potent trigger for dysbiosis, as the immune system reacts to the protein peptides of the offending foods by producing pro-inflammatory chemicals called cytokines that damage the intestinal mucosa, not only leading to a leaky gut but also making the environment inhospitable to the good flora.

In conditions such as Celiac, where the immune system is reacting to the family of gluten-related peptides, it’s been discovered that the gut microbiota plays a significant role in the development and progression of the illness.

Research has found that levels of beneficial flora such as Lactobacillus and Bifidobacteria in Celiac patients is much lower than in healthy individuals.7

Overall, higher incidence of gram-negative and pro-inflammatory bacteria present in the microbiota is linked to the symptoms associated with the disease by favoring the pathological progress of the disorder.7

Studies have also noted that a similar profile of decreased good bacteria and higher levels of bad bacteria are seen in the development of food sensitivities and allergies to milk, eggs, and nuts.7

It’s important to note that you can develop a food sensitivity or allergy at any time in your life to any food, not just the common ones (gluten, dairy, soy, corn, eggs, shellfish, and nuts).

GMO (genetically modified organism) or hybridized foods also represent a potent source for dysbiosis and the development of food sensitivities, as they aren’t as recognizable to your immune system as the original food form. This can trigger an inflammatory and immune response in the gut, potentiating dysbiosis.

Trigger of Dysbiosis: Environmental Toxins

Environmental toxins are everywhere—metals, volatile organic compounds (VOCs), and chemicals are found in the air, water, soil, industry, and products used on your body and in the home.

Food can also be a significant source of toxins depending upon where and how it’s grown, as well as if it’s processed.

If you’re a fan of grilling your food, you are adding yet another layer of toxins from the heterocyclic amines (HCAs) that are produced in the tasty charred portions. The cumulative effect of exposure to these substances over time can have a profound impact on the health of your intestinal microbiome, potentially leading to dysbiosis.

A 2008 study found that the volatile derivatives from metals such as mercury, arsenic, bismuth, and antimony exert their toxic effects on human health not only by direct interaction with host cells but also by disturbing the physiological gut microflora.18

The metals not only alter the composition of the organisms in the gut, but the bacteria themselves can transform the toxic metals into even more toxic compounds. Toxins of all kinds shift the balance of the flora into supporting the harmful organisms over the favorable ones.

Trigger of Dysbiosis: Infections

Toxins are not only acquired from the external environment but can also be prevalent internally, because they’re produced from infectious organisms such as certain bacteria, mold, yeast, viruses, and parasites. These organisms contribute to dysbiosis because they produce toxins that are detrimental to your body by:

Altering normal GI function: The organisms exert their damaging effects by decreasing gut motility, decreasing the amount of stomach acid and digestive enzymes, and altering bile production. These mechanisms help ensure their survival.16

Promoting inflammation: GI infections promote inflammation through the production of toxins such as lipopolysaccharides (LPS) in certain gram-negative bacteria and mycotoxins from mold. They also generate several different types of immune responses, which promote inflammation and also produce autoimmunity.16

Altering the GI flora: The gut microflora is often already compromised to some extent when a GI infection occurs. The infective organisms increase dysbiosis by their mere presence and by making the intestinal environment more hospitable to other pathogens and opportunistic commensal organisms (organisms that are normally found in the intestines of healthy individuals that take advantage of your compromised physiology).

After infectious organisms take hold, you may experience gas, bloating, diarrhea, constipation, or even no gut-related symptoms at all.

Brain fog, fatigue, sleeplessness, joint pain, depressed mood, and anxiety are often related to these infections. Some of the most common organisms include:

SIBO: Small intestinal bacterial overgrowth occurs when organisms from the colon inhabit the small intestine, where fewer bacteria reside.

Escherichia coli, Streptococcus, Staphylococcus, and Klebsiella are species frequently associated with SIBO. SIBO is complex, because the constituent organisms vary widely from person to person, as do symptoms, which can include constipation, diarrhea, gas, bloating, belching, stomach pain, malabsorption, brain fog, mood disorders, headaches, fatigue, and rashes, among others.

H. pylori: Helicobacter pylori is a spiral-shaped bacteria that is estimated to inhabit two-thirds of the world’s population. Some people happily coexist with it while others develop chronic conditions, because it can become opportunistic.

It alters immune function and stomach acid production to aid its survival while you experience reflux, indigestion, gas, bloating, and stomach pain.

Candida: Candida (yeast) is a fungus that lives in your mouth and intestines to aid with digestion and nutrient absorption.19 It can become pathogenic and rapidly increase in numbers if your immune system is compromised from stress or illness.

The infection can be almost anywhere in your body, from the mouth and stomach to the urinary tract, skin, and lungs. Some symptoms associated with Candida include sugar cravings, depression, anxiety, gas, bloating, headaches, rashes, and skin discoloration.

While the previously-mentioned infections are commonly related to dysbiosis, some important and often overlooked sources of infection include:

Mold: Mold is a fungus like Candida, and both are ubiquitous. Some common types of mold associated with dysbiosis include Aspergillus, Penicillium, Stachybotrys, and Alternaria.

The toxins produced from mold can be very harmful to the good gut bacteria and the host (you). These toxins produce symptoms ranging from mild to severe fatigue, sore throats, nosebleeds, headaches, diarrhea, brain fog, food sensitivities, and memory loss.

Tick-borne Illness: Tick-borne illnesses are prevalent primary infections or co-infections that can result in dysbiosis through several mechanisms.

First-line treatment of these infections often involves the use of antibiotics for weeks in acute cases and for months for chronic infections, killing off the good bacteria and promoting yeast overgrowth according to Dr. Leo Galland.21

These infections also result in “Bell’s Palsy of the gut,” ranging from paralysis of the gut to decreased GI motility, allowing dysbiosis to occur. 21,22

Lyme disease, an infection acquired through the bite of a tick infected with the bacteria Borrelia burgdorferi, is the most commonly-known infection. Babesia, Rickettsia (Rocky Mountain Spotted Fever), Ehrlichia, and Bartonella are also frequently identified as infectious bacteria from tick bites. Symptoms include rash, fatigue (often chronic), fever, aches, stiffness, brain fog, and constipation.

Viruses: Chronic viral infection is a common but often ignored cause of dysbiosis. Enteric (GI) viruses play an important role in the microflora of the gut, as they’re present in all of us and affect not only our gene expression but also the composition of the gut microbiota.

A 2014 study notes, “Viruses may act directly on the host epithelium and immune system to induce inflammation, or may alter luminal bacterial composition that then provokes disease.” 23

A further complication is that some viruses such as cytomegalovirus (CMV) and Epstein-Barr virus can remain latent after initial infection and only become active again under stress or immunosuppression, producing inflammation and GI symptoms that don’t appear to be related to the current pathological process.23

Symptoms and Effects of Dysbiosis

Alteration of the gut microbiome can have wide-ranging consequences on a person systemically—these effects aren’t limited to the gut.

The inflammatory process generated by dysbiosis is one of the primary root causes in many conditions.

The inflammation produces chemical changes in the body that activate the immune system, and it also increases or decreases the expression of certain genes, enabling the disease process to evolve.

What began as smoldering embers becomes a systemic wildfire when there’s no intervention or lifestyle change, allowing a simple process to potentially become a complex condition that is difficult to manage.

Treatment of dysbiosis can be as basic as using probiotics and gut-supporting nutrients in the most simple cases, or it can escalate to treating multiple infections and addressing autoimmunity in more complex cases.

Identifying and resolving all triggers and making appropriate lifelong lifestyle changes are key to reversing dysbiosis and eliminating inflammation.

The process of addressing triggers should begin with identification and elimination of all potential pathogenic GI infections through testing. Non-pathogenic bacterial overgrowth must also be identified and treated. This should be the first step of a comprehensive 5R program that includes these components:

1. Remove sources of irritation and inflammation:

Remove all sources of parasitic, fungal, and bacterial infections in the gut (from mouth to anus). If you take care of these without resolution of symptoms, look into viruses, mold, and other infections like tick-borne illnesses. Infections of the jaw from root canals and dental work are sometimes a source of hidden infection that should be investigated as well.

Try to eliminate the use of medications known to contribute to dysbiosis and irritation of the intestinal lining.

Refrain from alcohol consumption, as you’re trying to restore bacterial balance in the gut.

Reduce toxin exposure by eating organic when possible, using cleaner personal care and home products, and filtering your home air and water. Many green plants provide natural toxin filtration.

Prepare foods so that there are no charred areas produced. Marinating foods with lemon, garlic, and rosemary for several hours before cooking will help buffer the effects of any char that is produced.

2. Replace the nutrients your body needs to heal:

Beginning a meal with digestive enzymes and betaine hydrochloride will allow for proper breakdown and absorption of nutrients.

Prebiotic fiber such as FOS and inulin from onions, garlic, blueberries, asparagus, bananas, chicory, and artichoke promote the growth of beneficial bacteria and discourage harmful ones. Since these fibers are non-digestible by humans, the good flora can use them as a nutrient source. They also help prevent constipation and diarrhea by maintaining colonic balance.12

Fermented foods such as yogurt, kefir, kombucha, sauerkraut, kimchi, and some varieties of pickled vegetables are cultured with bacteria and yeast strains that help maintain intestinal flora.

Resistant starches, or starches that resist digestion until they reach the colon, can be found in raw potatoes, green bananas, green plantains, parboiled rice, lightly-cooked and cooled potatoes, or legumes (that have been soaked and sprouted). Once the resistant starches reach the colon, the bacteria digest or ferment them, producing short-chain fatty acids (SCFAs) that support bacteria and intestinal cell health and modulate inflammation. Added benefits are that they help improve insulin sensitivity, as well as blood sugar and body composition.

Soluble (completely fermentable) and insoluble fibers (little to no fermentation) like grains, fruits, vegetables, and psyllium also provide nutrients to the beneficial bacteria and help prevent constipation.12 They keep your bowels moving.

3. Re-inoculate with good bacteria to restore the flora:

Using a high-qualityprobiotic with at least 50 billion CFU twice daily will help restore the gut flora. Lactobacillus and Bifidobacter species are best in most cases; however, there are other beneficial strains that can be used. Start off using them slowly and work up to the recommended doses.

Fermented foods such as sauerkraut, kimchi, and kombucha, as well as kefir and yogurt (you can use dairy or non-dairy based), contain live, active cultures that will help the good bacteria stick around.

Dysbiosis often involves leaky gut as well as disruption of normal physiological processes of digestion, which all need to be addressed in order to maintain a healthy flora and GI function. This includes using betaine HCl to increase stomach acid, digestive enzymes to assist the pancreas, intestines, and liver until they produce adequate levels on their own, and sometimes ox bile to assist the liver in the digestion of fats.

Additionally, motility—the ability to keep waste and toxins moving through the GI tract—often needs to be repaired and restored. Ginger and d-limonene are good agents to stimulate GI motility. Exercise or movement and proper hydration are also great ways to keep the bowels moving.

Calming the nervous system and decreasing stress through breathing techniques, meditation, yoga, Tai Chi, or walks in nature are great ways to achieve this. Stress for most people is unavoidable, so learning to manage it through creating boundaries, learning to say no, or having a proper outlet to release it is key.

Exercise and movement are also essential in decreasing stress and maintaining the balance of the body and the brain.

One of the most important measures you can take is to fall asleep at a reasonable hour (10 pm is ideal), as well as get at least eight hours ofhigh quality, uninterrupted sleep. Sleep is crucial to the healing process, as well as the maintenance of overall good health.

My 28 day Autoimmune Paleo Rotation diet is complete! This was a great learning experience for me since I haven’t done an elimination this long in 2 years, and even more, never one this strict. This diet was more stringent than a typical rotation diet since it didn’t give any variability within each day as you’d normally get in a rotation. This makes it easier to plan and execute, in my opinion. You don’t have to think too much, kind of like wearing a uniform to school or work!

I feel great! I estimate my symptom reduction in the ballpark of 90-95%.

Itchy red bumps on my skin, random itching all over my body, light acne (associated with hormone fluctuations), and occasional headaches were my primary symptoms. I also tend to get ringing in my ears and a sore tongue or cankers with certain foods. The skin and tongue issues had been getting progressively worse, and if you recall from the beginning of my journey, I actually got a true hive. That was what I was afraid of all along! As often is the case in the healing process, sometimes things get worse before get better which I expected.

Now I only get the occasional itchy spot, not even every day. There’s no redness associated with it either. I haven’t had a headache (other than the virus) during the entire process. My tongue is much less reactive, and I realized might be my canary in the coal mine. It seems to be one of the first symptoms to show up when I have a reaction to a food. Similarly, my soft palate may also burn. Any symptoms related to hormones have significantly reduced too. I have more energy and better sleep too. I’d say this was a successful experiment!!

The High Points

New Baseline Established. This is a really important point. Now that I’ve had a significant reduction in symptoms, I have established a new baseline. When I reintroduce new foods and observe for symptoms, I’ll use this as my new set point to gauge any reactions.

The big take-away here is that your baseline can and will fluctuate with therapeutic interventions. At the beginning of the rotation, I’d say mine was a 7 (with 10 begin horrible symptoms), and now it’s a 1.5. It’s always important to have an idea where you’re at so you and any practitioner you work with can measure progress.

Simple Food Tastes Really Good. I’ve always been a fan of bold flavors, but I realized that eating food prepared in a simple manner can be amazing too. A “hash” of ground buffalo, kale, and sweet potatoes with a little sea salt and oregano is really tasty, as are many other combinations. Eating this way gives the opportunity for high quality ingredients to sing.

I Never Felt Deprived. This was probably the biggest revelation of all for me. I thought I’d miss having elaborately seasoned dishes with lots of ingredients, but even more, I thought I’d be starving. Neither were the case. I was surprisingly satiated the entire time. I made adjusts for increased physical demands on workout days, but I was never, ever starving. Nor did I ever feel like I was missing out by not being able to eat certain foods.

Symptoms Can be Confusing to Navigate Even for a Trained Professional. When you have lots of symptoms that fluctuate on a daily basis, especially at the beginning, it can be difficult to figure out what’s causing them. During those times, I relied heavily on my diary to track what I thought the likely culprits were. When I ate those foods again I knew to look out for reactions. I also knew not to combine them with the other suspect foods. I still don’t know with 100% certainty about a few foods. I’ll consider testing for them when I’m through the entire process if I think they’re still a possible issue.

The Healing Capacity of the Body is Amazing. I’d been experiencing my symptoms on and off for almost a year and a half. I’d take a couple foods out of my diet or try certain supplements, but nothing seemed to make them completely go away because I wasn’t doing the right things. I knew the first step was to do an elimination diet to get the food situation under control.

I’m shocked at how rapidly my symptoms declined. At the 2.5-3 week mark I largely felt as good as I do now. That’s pretty darn fast.

The Process Really Wasn’t Difficult. One of the biggest ways we tend to psych ourselves out is to think that doing something different will be hard, which often delays or prevents us from starting new things.

Once I wrapped my brain around what I needed to do and got into the groove, I was set. The first 2-3 days were a little rough, but I made it through and then it became my new routine. I plan on maintaining these new routines as they are since it was so easy to follow.

The Hard Truth…You Are The Only Thing Standing in Your Way. We are in control of ourselves- period. We often sabotage our goals with negative self-talk or excuses. We can come up with all sorts of reasons why it isn’t a good time to do an elimination diet, lose weight, or quit sugar, gluten, or smoking, but they are purely justifications to make ourselves feel better about not doing what we know we need to do.

We all have lives. There will always be work, events, holidays, finances, stress, etc.- that won’t change. What can change is how we think about things. That is what will allow you to achieve any goal you have.

During my month long elimination I had St. Patrick’s Day, Easter, and my birthday, as well as everyday life and a day long road trip. I decided not to let that stop me. I planned so that I could successfully make it through the process.

The Next Phase

Since I’m feeling so good I’m staying on the rotation in an expanded way for 2 more months. My plan is to add more foods back in systematically. I’ll test them on day one, and won’t add anything else new in for 2-3 more days. If I react to a food, I’ll keep it out of my diet for 3-6 months. If I don’t react, it will become part of my rotation.

In general, when adding foods back in, I usually start with things I like that I don’t seem to react to. I usually save possible problem foods for later.

I’m starting with eggs because I don’t think I react to them and REALLY miss them. So far, so good. No immediate reactions, so I’ll eat them again today two more times. I’ll watch for delayed responses to the eggs over the next 2-3 days. After that I’ll probably test walnuts, then pumpkin seeds. I’m not sure after that?? I’ll also continue to record everything.

I know in the past I may have had some type of reaction to tomatoes- usually cooked in combination with a high protein meal. That will probably be one of the last things I test since I know I’ve had issues in the past. I will also test raw tomatoes in a salad and see if I handle those in a different way since the preparation can be a factor as to if you’re going to have a reaction as well. For certain foods, it’s a good idea to test raw and cooked variations.

It’s never a good idea to jump back into your old habits or patterns that you had when you weren’t feeling well. Some people are just “dying” for certain foods and an alcoholic beverage. If that’s the case, you really need to check in with yourself and figure out where you’re feeling deprived or unfulfilled in your life because there’s a good chance you’re filling a void. No, you don’t need bread or cheese or ice cream, or beer, or whatever…. you want them. There’s a big difference.

Personalization

I believe another key to success and enjoying a diet of any kind, but especially a rotation diet, is to eat foods you like that are allowed on the program. There is always room for personalizing the menus to suit your tastes. Don’t be afraid to try new things either. I realized I liked lamb and collard greens, but don’t like dandelion greens.

Adjusting quantities to meet your caloric demands is also important. A 125 pound woman that does yoga and walks will need substantially less than a 125 pound woman that lifts heavy weights or trains for triathlons, or 225 pound guy that competes in strongman competitions.

Supplementation is another opportunity for personalizing. As discussed in the previous post, digestive enzymes and betaine HCL are good support supplements for a program like this, but many other types of supplements would work well here to support healing.

Once you’ve gone through the process of a 30 or 60 day elimination and still have some symptoms, testing may be the next logical step. GI infections are often the root cause of leaky gut and food intolerances, so identifying and treating them will often provide the last piece of the puzzle you need to heal and feel amazing.

I previously worked on Candida and some dysbiosis, so I’m focusing on rebuilding and supporting my flora as an ongoing part of my program.

Final Thoughts

This was an awesome experience that was long overdue because of my own procrastination. Once I get through the next month or two of the expanded rotation and testing foods, I’ll take what I’ve learned and apply it to my normal diet. I’ll keep the rotation feature in because I think it’s a bad idea to get into the habit of eating the same food daily. I’ll also expand my diet as wide as possible since I believe in varied nutrition- somewhere in the realm of Paleo-AIP plus. I add the “plus” because I know I handle certain foods well that aren’t considered Paleo or AIP. For example, I tolerate certain legumes and quinoa when prepared properly. While I don’t think it’s a great idea for me to eat them daily, I will eat them on rare occasion with no issues.

The take home message is to tune into your body and listen to what it tells you. Make adjustments as you need to. There’s a whole lot of wisdom and guidance at your fingertips every single day- you just need to be open to hearing it.

Completing 3 full weeks of this elimination diet has definitely enlightened me. This process is getting more and more interesting as I go through it! This week I tried ground lamb, collard greens, and sunchokes (Jerusalem artichokes) and loved them! I also had dandelion greens and hated them- so much so, that I tossed the whole batch after a couple of bites. Some experiments work, some don’t. Below are some more diet observations and thoughts about supplementation while on this rotation diet.

Diet Observations and Progress

Days 15 and 16 were not the best. First, my 3 year old got a virus on Easter that peaked on Monday (Day 15). The poor little guy was miserable and I was a little itchier than the previous day or two. My itching subsided after breakfast and I made it through the rest of the day relatively itch free. The following day however, the itching increased a bit, even after breakfast. To make matters worse, I got the virus too. I was congested, sore, and had a headache. I took a homeopathic blend, maitake mushroom extract, and upped my vitamin D, antioxidants, and probiotics to see if I could decrease the severity and duration of this lovely virus.

On Day 17 when I woke up something interesting happened. I was way less itchy (like 95% less) and it remained that way for the entire day. Not even a minor hint of irritation anywhere. I was also feeling better than the previous day. Still congested, but less fatigue and achiness. Nothing changed in my diet, so I assume the cocktail of supplements I took helped my immune system with the virus and my itching, so I decided to keep the regimen going.

Day 18 and 19 brought very minimal morning itching upon waking that left about 30 minutes later. I also felt much better concerning the virus. Symptoms were a down about 85%. I felt so good on Day 19, I went back to the gym. I didn’t push too hard and felt pretty good. I definitely got fatigued faster than usual, but listened to my body and backed off when I needed to.

I had another interesting finding on Day 19. I weighed myself and was 6 pounds lighter than Day 1. This diet is not calorie restrictive in any way. You can eat what is necessary to maintain your activity level. I believe a combination of factors contributed to the weight loss- decreased total calories, decreased total carbs, improved blood sugar handling, and decreasing inflammation. I eat 3, sometimes 4, whole meals per day and I feel completely satiated most of the time. This was really intriguing to me. I realized that even though I ate a 90% Paleo diet, I was still not regulating my blood sugar well since I’d often be ravenous 2-3 hours after a meal or shortly after a snack. Not good.

I also recognized that I am very sensitive to protein amounts and form. If I don’t eat enough whole food protein with my meal I’m prone to being hungry sooner. Before, I was eating too many “pre-digested” foods such as protein shakes and bars that didn’t help satiate me. Getting enough whole food based protein with fiber and fat= satiety and improved blood sugar regulation.

Increased energy and almost zero itching defined Days 20 and 21. Things are definitely moving in the right direction!!

At the end of 3 weeks, I have about a 95% reduction in the symptoms that prompted me to do this diet in the first place. I haven’t had any red bumps, welts, or hives in over a week, and the itching has significantly diminished.

I couldn’t be happier with my progress! I’m also learning more fine details since I’m paying so much attention to my body. I realized early in week three that if I have too much betaine HCl it makes me feel fatigued after a meal. I had upped my dose to 4. I didn’t feel much in the way of other symptoms, just profound fatigue. I backed the dose down to 2 (3 when eating certain meats) and feel fine again.

Supplementation

Taking supplements is always a very individualized experience. We usually don’t all need the same things, however, if you’re doing a program that is designed to decrease inflammation and heal the gut, then there are some things you can try to improve the program.

My top two for increasing nutrient absorption and taking stress off of the digestive system are Betaine HCl with Pepsin and Digestive Enzymes. Lacking enough of these can result in amino acids, vitamin, and mineral deficiencies, as well as an increased chance of GI infection from decreased barrier function and protection.

Probiotics also give you give good bang for your buck. During this program I’m taking both S. boulardii (10 billion cfu) and a 100 billion cfu Lactobacillus and Bifidobacterium blend. S. boulardii has many benefits, but I chose it since it improves host immune defense, decreases inflammation, and helps combat harmful microorganisms. I selected the blend because Lactobacillus and Bifidobacterium species support a balanced intestinal ecology and microbiota, enhance the immune response, and support bowel regularity and transit time (how long it takes your meal to get broken down, absorbed, and exit your body).

Beyond the above suggestions, I recommend adding most nutrients based on known depletions or imbalances, or for a specific reason such as getting sick. I added in the stack of a homeopathic, maitake mushrooms, with increased levels of vitamin D, an antioxidant blend, and probiotics since I knew I had a virus. I plan on doing this as long as I don’t feel well, but I’ll stop once I feel better.

Other supplements that are common for reducing inflammation are curcumin, boswellia, and higher dose fish oil. GI support and healing supplements include glutamine, n-acetyl glucosamine, colostrum or proline rich peptides (PRP).

I’m a fan a cycling supplements or using them when needed. There are very few things most of us need to take forever. Paying attention to your body can also help guide you. You may realize that something that once helped may now be an issue for you. Stop taking it or decrease the dose.

Keys to Success

Success in any lifestyle change, including diet, involves a few key steps that set the stage.

Planning. Plan your meals out one week at a time. Sit down on the weekend and outline what the next week will look like for every meal and snack. Each time you go to the store or farmer’s market (and you’ll definitely be going more than once per week if you’re eating fresh, whole foods) have your list. If they don’t have what you planned on, feel free to adjust on the fly. Just make a substitution!.

Also plan on how you’re going to prepare the food to accommodate your schedule. I started cooking earlier in the morning, or sometimes with a slow cooker overnight.

If you’re going out to eat, look for places ahead of time that can accommodate your needs. Don’t be afraid to call. So many restaurants now are willing to accommodate dietary needs- you just need to ask.

Planning takes away guessing and stress!

Record everything. I have a spreadsheet that has columns for my protein, fat, carb, and seasoning sources (also doubles as my grocery list). I also record any symptoms, improvements, general observations, and changes I make (such as adding or eliminating supplements or foods). This makes it easier to make necessary adjustments and have an accurate record of what actually happened rather than guessing.

Be mindful. Tune into your body and pay attention to everything. How do you feel mentally and physically during the diet? Do certain foods give you reactions? Do you feel more energy? There is endless input that your body provides as feedback. Take note and respond accordingly.

Also be grateful for each meal. Everything on your plate was once a living organism that was harvested to provide you with life giving energy. That’s something to be tremendously appreciative of.

Reduce your stress. Your body will heal faster the more you reduce your stress. If you feel stressed, take a step back and do some deep breathing or sit and meditate for a few minutes. Journal, exercise, talk, dance…. Do whatever it is that makes you feel good.

Minimizing your sources of stress is helpful too. Reduce your responsibilities, ask for help, and say “no”. These are empowering tools if you use them.

Be adventurous. I mentioned at the beginning of this post that I tried several new foods. I loved some and hated some, but the point is that I tried. You’ll never know if you actually like something or not unless you step out of your comfort zone and try it. Some of the ugliest and scariest sounding foods are quite tasty.

Practice self-forgiveness. If you slip up it’s not the end of the world. Get back on track and keep moving forward. We’re all human.

Enlist support. Having a buddy to go through this with is always helpful, but if you don’t have one, let your friends or family know what you’re doing and why it’s important. There are also online forums that can provide support too.

I’m excited to see what’s in store for the final week. I hope the positive trend continues! Next week I’ll discuss food as medicine and big picture take-aways.

Week number two is in the books! There was definitely less drama on the skin side (no hives or red bumps= win), but there were definite peaks and valleys. Overall I’m feeling great for the most part.

Diet Observations

Monday was Day 8 and I felt amazing 90% of the time. I had lots of energy and significantly less itching than Saturday and Sunday. My workout was great and my brain was firing on all cylinders. The only bump in the road on this day was a little gas with my acorn squash at dinner. I plan on testing that again soon to see if it was random, or if I have issues with acorn squash.

I added in progesterone (only cycle days 15-28), DHEA, licorice root extract, an adaptogenic herb blend, and vitamin C to help support my hormones and adrenals again. Curious to see if it makes a significant difference in my symptoms. I’ve been recovering from adrenal fatigue and major hormone depletion since the birth of my son 3 years ago. It’s considerably better, but far from 100%.

Days 9 and 10 were positive as well, with high energy all day, however, the itchy skin and runny nose seemed to be making a bit of a comeback. By the evening on Day 10, I considered the itching moderate. It’s strange too since there’s a completely random distribution- palm of hand, scalp, belly, or arm- really anywhere. There aren’t any red spots or welts of anymore, just itchy skin that isn’t even pink or red most of the time. I’m still trying to make the connection between certain foods and the itching flares, but there’s no obvious link yet. I have a few other theories on my itching too, but I’d like to see if I can eliminate the GI causes first.

Another Day 10 observation was that I have a harder time breaking down shredded beef than ground beef. I felt as if it was sitting in my stomach for a long time despite having taken my usual amounts of HCl and digestive enzymes. Seems odd, however, the ground beef is already in smaller pieces and easier to chew. I noticed by the end of the day my jaw hurt from so much chewing. I suspect I got a little lazy and wasn’t chewing enough by the end of the day which contributed to the poor digestion.

Day 11 was similar to the previous 2 days, except that I had a little more fatigue in the morning that I suspect was from a killer workout the day before. I knew I’d need to take it easy and do light recovery movements so I wouldn’t over stress my adrenals and nervous system. A positive was that my skin was looking clear and radiant. No sign of any acne or redness. Win!

Anyone that’s done an elimination diet knows eating out can be traumatic, so I was excited and nervous for Day 12. I went out to lunch with my sister which meant extra planning. Luckily, we are blessed to have some local, truly Paleo restaurants here which made my day much easier. Agra Culture Kitchen and Press is an amazing choice if you want healthy food in the Twin Cities. They cater to many diet variations- Paleo, gluten free, vegan, vegetarian, fresh pressed juices and Bulletproof coffee (which I really miss). They made my meal out of the house very easy and stress free. Anyhow…this day was short of miraculous. I was symptom free 90% of the day! No itching (my worst symptom), no runny nose, no NOTHING!!

My nirvana didn’t last on Day 13, sadly. The itching resumed at a low level in the morning, but after breakfast it was gone again. The main issue today was that I was hangry (hungry and angry). This is usually a result of low blood sugar. I set myself up for disaster since I ate breakfast 2 hours late, which lead to a day of grouchiness (my husband didn’t appreciate it… sorry dear). Clearly my adrenals and blood sugar are still not 100% which I already assumed.

Meal timing and content are important when you have adrenal fatigue. If your calories or carbs are too low, you will feel fatigued and sluggish mentally. Eating at least every 4 hours is a good idea to keep blood sugar and energy levels even throughout the day. That’ll keep the people around you happier too!

Day 14 was similar to the previous day in that I started out itchy, but it went away fairly early in the day.

Week two was definitely better than week one with several wins and a decrease in symptoms. So far, so good.

Adjusting Your Program on the Fly

I never operate in a “set in stone” manner, nor do I expect my clients to either. Humans have a complex physiology with a seemingly infinite number of variables (many of which we don’t know much about yet). We need to pay attention and tune in to what is happening when we change the inputs (diet, supplements, exercise, stress, sleep, etc.) and adjust accordingly to our own individual needs.

Here are some of the modifications I’m making:

Sticking to lower histamine foods given my reactions in week 1. The histamine issue may be worse than I thought, so I’m trying not to eat leftovers either (which sucks a bit since I’d mostly been making my meals for the day in the morning). Freshly cooked is best with histamine. I’ve also axed fish and shellfish for now which saddens me because I love them. I also realized I may need to test methylation, Candida, and my gut microflora as those can be causes of histamine issues.

Adding in supplements when necessary. I realized I need to use more HCl and enzymes with certain proteins that I don’t seem to breakdown as efficiently. I add in one extra cap of each. I also added in a DAO enzyme supplement to help clear histamine when necessary.

In order to maintain my energy and facilitate recovery post-workouts I added in an amino acid powder with no additives immediately after my workout, plus an extra meal later that day.

There will probably be more to come. The point is that you need to be alert to what your body is telling you and listen.

Hard Workouts are Possible on a Strict Elimination Diet

One of my biggest fears, and why I put this elimination off for so long, was that I thought it would kill my workouts and recovery. You can’t use protein powders like whey, beef or pea, and many supplements you’d replace those with are off the table as well.

This elimination is about as strict as they come, however, it doesn’t limit quantity which is helpful. I also wasn’t used to eating so many purely whole food meals in a day. I have a shake for breakfast half the time and always have one after workouts.

Surprisingly, my experience has been exactly the opposite of what I expected. I generally have more energy and feel more satiated during the day.

My workouts are 80% weight lifting and 20% metabolic conditioning. Certain days are definitely more taxing than others. I do this 3 times per week and fill in the other days with hiking, sprinting, mobility work, or riding my mountain bike. As a rule though, I always have rest days and listen to my body. If I’m feeling really fatigued I don’t push as hard or I skip a day. I’ve suffered severe adrenal fatigue and really don’t want to go there again.

I eat my breakfast 60 minutes before my workouts to give enough time to digest. I adjust the portion down sometimes if I feel I won’t be digested enough. I’m also taking vitamins and supplements that support energy metabolism (which I also did before).

The second workout during week one was when I noticed a little more fatigue which could’ve just been part of the adjustment period, but I made some changes to be safe. As soon as my workout is done, I have my straight amino acid powder and try to eat within 30-45 minutes to replenish my muscles and prevent excessive soreness. To further aid in recovery, I often add in a fourth meal if I’m feeling a little hungrier.

Strength and endurance haven’t decreased 2 weeks in which I’m ecstatic about. I’m hoping I can maintain this throughout the duration. So far, lots of energy and normal levels of post-workout soreness and fatigue.

Next week I’ll discuss supplementation and keys to success, as well as my progress update!

As a rule I try to practice what I preach. I also like to try everything that I can before I recommend it to a client, because if I can’t do it, I’m surely not going to recommend it to my clients. Following my own advice, I decided it was time to embark on the Autoimmune Paleo (AIP) rotation diet I’d been procrastinating on. I’ve been having odd symptoms such as single itchy, red, bumps that look like bug bites that show up on the flexor surfaces of my body (think areas with creases like arms, hands, legs, etc.), mild acne, occasional sleep issues, and an irritated tongue with certain foods.

I put it off like most people because there wasn’t a good time- family events, my birthday, travel… the list was long. Timing is just a ridiculous excuse. No time is ever a really good time- you just need to do it. With the gentle nudging from a good friend that is a hard core advocate of the diet, I jumped in.

It required much preparation and planning, but now that I’m one full week into it there’s no problem. I’ll admit I was hesitant because my mornings are busy with a toddler I have to get ready for school, getting myself ready, and work. I had to add food prep to this, but now it’s a cinch since I pre-planned my menu for the week and will sometimes cook things the night before. I’ve developed a rhythm and it’s working, which truly is one of the keys to success of any protocol or habit change.

I thought it would be interesting to share the details of my experience with you since I often ask people to rotate their diet on an SCD, GAPS, Paleo, AIP, FODMAP, or low histamine diet. So here it goes!

The first 2 days sucked! I was tired, brain was foggy, and I was still really itchy. Day 2 was actually worse because I got a headache to boot. This isn’t unusual and I expected it, because anytime you change inputs to the body you often get push back. I suspect my symptoms were largely due to no coffee, less carbs, less total calories, and possible detoxification shifts. A bonus was that I felt completely satiated all day long both days and this NEVER happens for me.

Days 3 and 4 I felt much better- clear brain, more energy, and my itching had decreased. Yay! The only negatives were a little bit of a runny nose with meals and I was extra sore from workouts since I wasn’t having my regular post workout shake. I decide to add in a smaller 4th daily meal right after the workout which helped.

Day 5 was similar to days 3 and 4, but I didn’t have a bowel movement. Red flag! That’s not what I want to see happening and I wasn’t sure why… yet.

I went downhill fast on day 6 and the lack of bowel movements continued. That morning after I ate my breakfast I was super itchy, got an actual hive for the first time, my runny nose was out of control, my tongue was irritated, and I slept horribly. The light bulb went off in my head and I realized I had eaten foods that I had long suspected I had issues with (plantains and avocado) or those with higher histamines (shellfish) over the previous few days. This was enough to trigger a fairly significant inflammatory reaction in my body. I took some anti-inflammatory enzymes, DAO, high dose vitamin C and fish oil which got the reaction to calm down in less than 12 hours. This illustrates a huge point I always tell my clients: even though a diet says you can eat a food, it may not be tolerated by your body!! We all need to individualize our diets for our own needs.

Day 7 was definitely better. The hive was gone, the itching and runny nose significantly decreased, sleep was better, and the BMs returned! I’m still feeling completely satiated on 3-4 simple, whole food based meals per day and I’m back on track. Next week I’ll report back on my progress and talk about how to deal with workouts and performance on diets like this.